Touch-Point Mathematics Instruction for Children with Autism

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Touch-Point Mathematics Instruction for Children with

Autism Spectrum Disorder: A Systematic Literature

Review

Nur Amira Yusaini, Siti Mistima Maat, Roslinda Rosli

To Link this Article: http://dx.doi.org/10.6007/IJARBSS/v9-i3/5730 DOI: 10.6007/IJARBSS/v9-i3/5730

Received: 04 Feb 2019, Revised: 23 Feb 2019, Accepted: 21 March 2019

Published Online: 03 April 2019

In-Text Citation: (Yusaini, Maat, & Rosli, 2019)

To Cite this Article: Yusaini, N. A., Maat, S. M., & Rosli, R. (2019). Touch-Point Mathematics Instruction for

Children with Autism Spectrum Disorder: A Systematic Literature Review. International Journal of Academic

Research in Business and Social Sciences, 9(3), 609–625.

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Vol. 9, No. 3, 2019, Pg. 609 - 625

http://hrmars.com/index.php/pages/detail/IJARBSS

JOURNAL HOMEPAGE

Touch-Point Mathematics Instruction for

Children with Autism Spectrum Disorder: A

Systematic Literature Review

Nur Amira Yusaini, Siti Mistima Maat, Roslinda Rosli

Faculty of Education, National University of Malaysia

Email: [email protected], [email protected], [email protected]

ABSTRACT

Children with Autism Spectrum Disorder (ASD) often face some problems in mastering basic

numeracy skills. A touch point is a multisensory method that has been introduced especially

for children with ASD as it is one of a proven way of improving their achievement in

mathematics. Thus, this systematic literature review is conducted (a) to identify the

characteristics of participants and suitability of touch points interventions based on the

characteristics of children with ASD and (b) to evaluate the effectiveness of touch point

interventions in improving the achievement of children with ASD. Overall, the empirical studies

indicated that the touch point mathematics instruction commonly used in teaching primary

school students on basic mathematical knowledge such as numbers and arithmetical

operation skills. Hence, the touch point was effective in helping teachers to help children with

ASD in learning basic mathematics. Implications are discussed.

Keywords: Autism Spectrum Disorder (Asd), Mathematics Interventions, Numeracy, Hands-On

Approach.

INTRODUCTION

Autism Spectrum Disorder (ASD) is defined as a lifelong disability that has been characterized

by impairments in communication, social interaction as well as limited and repetitive

behaviors and interests (American Psychological Association [APA], 2013). According to

Schmidt and Bonds-Raacke (2013), ASD is a type of disorder that includes individuals with

autism and Asperger syndrome also extensive of a developmental disorder. Individuals with

autism often experienced three types of impairments wherein includes verbal and non-verbal

communication, socialization, and distraction to environmental changes (Burney, 2015;

McCrimmon & Yule, 2017; O’Malley et al., 2014; Schmidt & Bonds-Raacke, 2013; Su et al.,

2012).

The disability of ASD can adversely affect the education performance of children with

autism (Burney, 2015; O’Malley et al., 2014; Schmidt & Bonds-Raacke, 2013) which in turn

will cause them to be left behind by their peers. The problems that enormously affect children

with autism are mastering in basic mathematical skills (Burney, 2015; O’Malley et al., 2014),

reading, writing, speaking and also their ability in completing tasks individually (Burton et al.,

2013; Holifield et al., 2010; O’Malley et al,. 2014). This education and skills are an essential

element for them to live life and to build the foundation for more complex numeracy skills

(Jowett et al., 2012; O’Malley et al., 2014). The mastery of basic skills in mathematics is a part

of critical skills that can determine the individuals’ achievement in mathematics (Royer, 1999).

Basic skills in mathematics include number identification, addition, subtraction,

multiplication, and division involving single digit number, problem-solving, learning about

money and time units (Berry, 2012; Yıkmış, 2016).

According to Yıkmış (2016), the addition process involving single-digit numbers and

obtaining two digit numbers also known as essential mathematical skill. However, if children’s

early understanding of mathematical concepts is not well developed, they will have difficulty

in understanding the next level of mathematics in primary school. This will lead most of ASD’s

children with average and inferior intellectual development struggle in order to understand

the basic mathematical skills (Burney, 2015) yet showing continuous difficulty in basic

calculation and problem solving which in turns give low standards of mathematics

achievement (Browder et al., 2012; O’Malley et al., 2014; Spooner et al,. 2018).

Numeracy skills for children with ASD

Numeracy can be defined as the efficiency in performing basic mathematical operations and

the ability to apply such knowledge in the context of real life (NCTM 2012; KPM 2010). Siti

Rahaimah (2014) states numeracy is an essential topic of mathematics in primary and

secondary school. Numeracy is the basis for the continuation of mathematical learning at the

next level. Apart from that, numeracy is also more geared towards the ability to use

mathematical knowledge and skills in solving problems (Asiahwati, 2015; Geary, 2011; Geiger

et al., 2013; Jordan et al.,. 2009; Sarama & Clements, 2008). The significance of numeracy

should be given attention to the early stages of learning, especially for the basic skills that the

children should be required in mathematics (Siti Rahaimah, 2014).

Therefore, various forms of early mathematical interventions are often carried out

to aim in helping the mathematics achievement of children with ASD at all levels and to avoid

them having problems in learning mathematics (Shanley et al., 2013). Several practical

teaching skills showed to be highly effective for children with ASD. Among them are the

delivery of systematic and explicit directions, peer-to-peer learning and visual display (Besler

& Kurt, 2016; O’Malley et al., 2014). Besler and Kurt (2016) also point out that one of the most

effective teaching methods is to show how the skills are demonstrated. Nevertheless, the

rapid adoption of computer-based technology in the classroom today makes concrete

materials as teaching aids less used although, for decades, these materials are believed to

help students with learning disabilities (Cihak & Foust, 2008; Satsangi et al., 2016). As a result,

children with ASD often make writing skills as a challenging skill (Zajic et al., 2016). Still, Burney

(2015) and Cihak and Foust (2008) affirmed that students could even develop basic

mathematical concepts using concrete materials.

Touchpoints intervention facilitates children with ASD in mastering numeracy skill

Behind the use of rapid technology as a teaching aid tools (Satsangi et al., 2016), more and

more studies have been made on new and innovative interventions such as TouchMath

programme (Bullock et al., 1989) also known as a touch point. Touchpoint is a multisensory

method that involves visual, auditory and tactile learning (Calik & Kargin, 2010) especially for

children with disabilities and had ASD (Calik & Kargin, 2010; Cihak & Foust, 2008; Simon &

Hanrahan, 2004; Waters & Boon, 2011).

This method use dot-notation to teach mathematical skills (Cihak & Foust, 2008; Simon &

Hanrahan 2004; Waters & Boon 2011) which the children mark the points that appear on the

numbers and dots in the circle while looking at the number (visual) and calculate the amount

(auditory) using a pencil (tactile). The children are taught to count the points found on each

number representing the actual quantity of the number (Berry, 2012; Waters & Boon, 2011)

as shown in Figure 1.

Figure 1. Touchpoints system representation developed by Bullock et al. (1989)

This method has showed a few results with positive effects in improving the

student’s performance with or without problems in understanding the basic concepts of

mathematics (Waters & Boon 2011). It has been proven successful in solving addition and

subtraction problems with single digit (Avant & Heller, 2011; Berry, 2012; Cihak & Foust, 2008;

Rudolph, 2008; Wisniewski & Smith, 2002) and two digits (Calik & Kargin 2010; Simon &

Hanrahan, 2004; Waters & Boon, 2011; Yıkmış, 2016) specifically for children with ASD who

confront with problems in learning basic numeracy skills.

The necessity of early intervention was to address the learning problems they faced.

Ping Yee and Mohd Ali (2008) states that one of the purposes of early intervention is to

enhance the confidence level of children with ASD to apply basic numeracy skills in everyday

life. Therefore, to ensure their basic mathematical knowledge is at the finest level,

interventions need to be carried out to ascertain the rationality of teaching methods.

Furthermore, the best way to help children with learning disabilities is by using concrete

materials (Berry, 2012; Calik & Kargin, 2010; Cihak & Foust, 2008; Simon & Hanrahan, 2004;

Yıkmış, 2016) considering the instructions given with the use of concrete materials as

manipulative tools facilitate the children with ASD to understand the concepts of

mathematical skills learned. Thus, a touch point is chosen as an intervention as it is a

multisensory method that applies to children with ASD.

There are three recent literature syntheses have reviewed on mathematics

intervention for the same population. First, Cindy et al. (2016) discussed mathematics

intervention that focused on students with ASD and the studies are within the area. Thirty

studies for the academic content area that have been published between the year of 1987

and 2015 were included as studies that meet research criteria. Second, King et al. (2016) have

reviewed on mathematics intervention studies which also focused on children with ASD and

intellectual disabilities involving 14 academic studies that were published around 1988 until

2014. Third, Lemons et al. (2015) have reviewed mathematics intervention for both children

and adult with ASD and down syndrome. Lemons et al. (2015) studies involved nine academic

studies between the years of 1989 and 2012. This present study is emphasized on the review

on mathematics intervention using touch points, determine additional studies, classify touch

points according to the characteristics of the study participants to identify the suitability of

interventions and the effectiveness in improving the achievement of children with ASD.

Research questions

The research questions that guided this systematic literature review are: What kind of studies

published in journals that engaged touch points intervention to assess children with ASD?

Specifically, the aims of this study are:

(a) to identify the characteristics of participants, findings and suitability of touch point

intervention based on the characteristics of children with ASD and;

(b) to assess the effectiveness of touch point intervention in improving the mathematics

achievement of children with ASD.

METHODOLOGY

The method used to conduct this review is PRISMA (Preferred Reporting Items for Systematic

Review and Meta-Analyses). In short, PRISMA is a form of reporting for systematic review and

meta-analysis that focus on reporting survey to assess random trials but also used as a basis

for reporting systematic review, particularly for intervention assessment.

Inclusion Criteria

Studies with the following criteria are included: (a) touch point intervention with at least one

dependent measure of mathematics-related outcomes is evaluated, (b) involved at least one

participant with ASD by assessing the effectiveness of touch point intervention on the

experimental group or single-subject design and (c) used an experimental design. The findings

with a focus of mathematical accuracy are accepted (e.g., the percentage of correct

responses).

Search Procedures

We identified the relevant articles through search procedures consisting of four phases (see

Figure 2). Specifically, we conducted (1) electronics database search, (2) a review of recent

systematics journals, (3) a hand search of relevant journals and (4) an ancestral search of

identified articles.

First, three searches of databases are used, Educational Resources in Education

Clearinghouse (ERIC), SAGE Journals dan Google Scholar. The first search used the terms

("autism" OR "autism*") AND ("intervention" OR "mathematics" OR "math" OR "numeracy"

OR "arithmetic" OR "addition" OR "subtraction" OR "algebra" OR "count"). While the other

search replaced the second set of terms with "Touch-Points" OR "TouchMath" OR

"multisensory approach." At this phase, the search is limited to the first ten years of publishing

which is from 2008 to 2018. All of the reviewed article journals yield 527 records and 12

articles with full text. Five of these met the inclusion criteria.

Figure 2 Study identification procedures

Second, the list of seven published recent reviews related to mathematics intervention

for children with ASD is reviewed (Aydemir, 2015; Burney, 2015; Cihak & Foust, 2008;

Gevarter et al., 2016; Lemons et al., 2015; Spooner et al., 2018; Whalon et al., 2015). From

the search of 116 journal articles, ten articles with full text covering technology-based

interventions, concrete materials, and touch points methods are chosen. One of these met

the inclusion criteria.

Third, a hand search of relevant journal articles according to the year published

between 1980 to 2018 is conducted for the following journals: American Journal of

Intellectual and Developmental Disabilities, Education and Treatment of Children,

Developmental Neuropsychology, International Journal of Special Education, Journal of

Intellectual Disability Research, Journal of Special Education, Exceptional Children, Remedial

and Special Education, Journal on Developmental Disabilities, Research and Practice for

Person with Severe Disabilities dan Research in Developmental Disabilities. At this stage, the

search is broadened to the year of 1980 until 2018. The year 1980 was used because that was

the first year autism was a separate diagnostic category in the Diagnostic and Statistical

Manual of Mental Disorder (Gevarter et al., 2016). The search at this phase yield 2,077 journal

articles and 50 articles with full text are identified. Two of these met the inclusion criteria.

Fourth, an ancestral search by reviewing the references of articles were identified up to this

point of search. From the pursuit of 50 journal articles, 14 articles were identified that focused

on mathematical interventions using the touch point method for children with ASD. All of

these nine articles are published between the year of 1983 and 2016 identified for inclusion.

Coding Procedures

The information for each of the study has been categorized based on the variables:

participants, setting, instrument, mathematical skills focused and the findings. The coding

procedures for participants of the study are based on items: age, gender, ASD level and level

of mathematical performance. While the coding procedures for setting include the location

of research has been conducted in general (e.g., school) or specific (e.g., classroom in a school)

and the intervention situation (e.g., group or study). Instrument encoding includes all

manipulative materials used such as touch point worksheets and additional equipment as

complementary to convey instructions. Mathematical skills focused are a mathematical skill

developed using intervention to improve students’ mathematical performance (e.g., addition,

subtraction, multiplication, and money). The coding procedures for findings are to measure

the mathematical accuracy (e.g., percentages of correct responses).

FINDINGS AND DISCUSSION

In the following section, the discussion of the research findings focused on the previous

research that has been included in Table 1 for answering the research question.

Characteristics of participants and suitability of touch point interventions

Fourteen intervention studies using touchpoint have been selected meet the inclusion criteria

are between the years of 1983 and 2016 sorted descending by year as shown in Table 1. All

of the studies involved 239 participants with ASD with a mean age of 7 (from 5 years old to 9

years old). Among the 14 studies selected, ten journal articles conducted a single-subject

design with 41 participants in total (24 males, 17 females) and the rest were held using group

experimental design with 198 participants in total. All of these studies with the single-subject

design carried out intervention for 15 to 180 minutes individually. While group experimental

design was conducting group intervention sessions either with 3 to 4 participants in a group

or whole-class involvement. Most of the interventions sessions take place in a class or

separate room to prevent any interference.

All the studies used intervention focused on improving the basic mathematical skills

of children with ASD on addition and subtraction. Ten studies focused on addition skills in

which eight studies (Akmanoglu & Batu, 2004; Avant & Heller, 2011; Calik & Kargin, 2010;

Cihak & Foust, 2008; Fletcher et al., 2010; Rudolph, 2008; Wisniewski & Smith, 2002; Yıkmış,

2016) investigated addition with one digit and two studies were in addition with single and

double-digits (Simon & Hanrahan, 2004; Strand, 2003). On the other hand, there is a study

(Waters & Boon, 2011) used touch points intervention to focus on subtraction skill to learn

about money. The remaining three studies focused on both addition and subtraction skills

with two studies conducted single digit addition and subtraction (Berry, 2012; Thornton et al.,

1983), and one study conducted the single and double-digit addition and subtraction (Scott

1993). Based on the characteristics of the participants involved in this study, it can be seen

that the primary school students were the most participants involved. This finding suggested

that the touch point method was used in teaching the basic mathematical knowledge to

primary school students. However, due to the limited number of high-quality studies, we have

not been able to identify the suitability of touch point intervention based on the

characteristics of ASD’s children and evaluate the effectiveness of touch point intervention in

improving mathematical achievement for them accurately.

Table 1. Descriptions of participants, settings, focused skills, instruments, and findings

Researcher

(s)

Participants

Settings

Focused skills

Instruments

Findings

Yikmis

(2016)

Three males (8 – 10),

diagnosed with ASD.

Intervention held in a

class (4 x 3 m)

individually.

Practitioner and

participant sat face to

face. There was no other

person in the classroom

except the practitioner

and participant.

Single-digit addition

that has a single-digit

sum.

A video camera was

used to record and

worksheets with ten

addition questions with

touchpoint strategy.

Emrah, Doruk, and Seyit

showed a success rate from 0%

to 100% at the end of 12

intervention sessions and

managed to maintain the

performance at the end of 14

sessions.

Berry

(2012)

Ten males, diagnosed

with ASD.

Intervention sessions

held in the class

individually.

Instructions begin with

one to one training

areas.

Single-digit addition

and subtraction.

Pen, pencil and three

worksheets of addition

and subtraction

problems with

touchpoint strategy.

Every sheet has the

same difficulty level.

8 out of 10 participants showed

the ability and effectiveness of

using touch-point and able to

maintain the performance.

2 out of 10 were not capable of

using touchpoint strategy and

require calculator as additional

support.

Waters &

Boon

(2011)

Three males (14 - 16),

secondary school

students, diagnosed

with ASD and mild

intellectual disabilities.

Intervention sessions

held in a special

education class (3 x 6.5

m) individually. Teacher

and participants are sat

face to face during the

intervention sessions

Subtraction for the

topic of money.

A poster contains

numbers 1 to 9 with

touch points are used

and pasted on the walls

for instructions.

Worksheets of

subtraction problems

are used.

The trend showed an increase

from 6.66% to 75.55%

(increased by 68.88%), Michael

showed a rise from 5% to 88%

(increased by 83%), and Alex

showed an increase from

2.22% to 76% (increased by

73.77%).

Avant &

Heller

(2011)

Two males and one

female (7 – 9),

diagnosed with autism

and physical

disabilities.

Basic addition

problems up to 20.

TouchMath number kit

produced by the

Innovative Learning

Concept (Bullock, 1999).

Amy showed an increase from

33% to 100%, Bob showed a

rise from 42% to 100%, Connor

showed an increase from 17%

to 100%.

Fletcher,

Boon &

Cihak (2010)

Two males and one

female (13 – 14),

diagnosed with ASD

and mild intellectual

disabilities.

Intervention sessions

held in a self-contained

classroom with each of

the participants

individually.

Addition

Two types of

worksheets, A and B

with different addition

problems but at the

same level of difficulty.

Worksheet A used a

touch point strategy to

solve problems.

Worksheet B used a

number line strategy to

solve problems.

Ashley showed 30% of

increment using the number

line and 98% using the touch

point. Robert showed 100% of

increase using both number

line and touch point. Ken

showed 40% of increase using a

number line and 100% using

the touch point.

Calik &

Kargin (2010)

One male and two

females (8) diagnosed

with ASD and mild

physical disabilities.

Intervention sessions

held in a classroom at

the participant's school.

Table and chairs are

provided for the teacher

and participants. A set of

recordings is installed for

data collection purposes

and intervention

reliability.

Basic addition

Worksheets contain a

different kind of addition

problems at the same

level.

At the end of 9 sessions,

Participant A showed an

increase from 30% to 100%,

Participant B showed an

increase from 40% to 100%,

Participant C showed an

increase from 30% to 100%. All

of the participants were able to

maintain performance until the

control sessions were

conducted.

Cihak &

Foust (2008)

One male and two

females (7 – 8),

diagnosed with

autism and mild

intellectual

disabilities.

All of the intervention

sessions were conducted

in a classroom at the

school of participants

and free from any

interruption.

Single-digit basic

addition.

Two types of worksheets

with touch point and

number line strategies

for each sheet with

different addition

problems but at the

same level of difficulty.

Travis showed an increase from

2% to 74% after 12 sessions. Ivy

showed an increase from 0% to

70% after 12 sessions. Gina

showed an increase from 0% to

71% after 16 sessions.

Rudolph

(2008)

A whole class with 17

students. 5% with

Academically

Intellectual Gifted

(AIG), 35% are

Exceptional Children

(EC), 60% are

Attention Deficit

Hyperactivity Disorder

ADHD.

Intervention sessions

conducted in a classroom

equipped with math

manipulative technology

and materials.

Basic mathematics

addition

Sixteen participants showed up

to 25% increment. While 1

participant was not able to use

the touch point strategy has

decreased by 32%.

Akmanoglu

& Batu

(2004)

Two males and one

female (6 -17),

diagnosed with ASD.

Intervention sessions for

Omer and Baris held in a

classroom at their

school. Intervention

sessions for Serap held in

a school at a university.

Each class provided a

table and chairs for the

practitioner and

participants.

Addition

White cards (10 x 15 cm)

and black numerals

written on the card.

Video and stopwatch to

control intervention

sessions.

Baris showed an increase from

89% to 100%. Omer showed an

increase from 84% to 100%.

Serap showed 100% of

increment.

Simon &

Hanrahan

(2004)

One male and two

females (10),

diagnosed with ASD

and low intellectual

disabilities

Intervention sessions

held in a private room on

Tuesday, Wednesday

and Friday, and free from

interruption

Single and double-

digits additional

problems

Worksheets with 12

single and double-digit

addition problems

sorted according to the

difficulty level.

Participant A showed an

increase from 47.2% to 81.9%.

Participant B showed an

increase from 1.4% to 92.56%.

Participant C showed an

increase from 74% to 97.2%.

Strand

(2003)

Involved two groups

of students at the

same level, Group I

(treatment), Group II

(control).

Group I consists of 59

students from two

schools (A: 37, B: 22).

Group II consists of 61

students from the

same school.

Intervention sessions

held in each class.

Single and double-

digit addition

Worksheets were

containing 16 math

problems with different

difficulty levels.

Group I showed the ability to

answer additional problems

with 80% of correct responses,

while Group II showed the

ability to solve the additional

problems with 40% of correct

responses.

Wisniewski &

Smith (2002)

Four participants (3 –

4) received special

education within 3 to

3 hours and a half

daily.

Intervention session held

in the participant's

classroom.

Addition

A poster contains

numbers one to nine

with touch point are

pasted in front of the

class as students’

references.

Worksheets contain

touch-point are used.

The video recorder was

set to record

intervention sessions.

Participant 1 showed an

increase of 85% to 100%.

Participant 2 showed a

decrease of 98% to 95%.

Participant 3 showed the same

achievement (100%) before

and after the intervention.

Participant 4 showed an

improvement of 23% to 93%.

Scott (1993)

Three participants (8)

diagnosed with ASD

and mild intellectual

disabilities.

Intervention sessions

held in a library’s class.

Each session runs for 2

hours per day.

Single, double and

triple digit addition

and subtraction.

Twenty-four worksheets

(single digit: 8; double-

digits: 8; triple-digits: 8),

a poster of touch points

posted on the wall for

participants’ references.

Participant 1 showed an

increment of 96% within three

days of intervention sessions.

Participant 2 showed an

increase of 100% within two

days of intervention sessions.

Participant 3 showed an

increment of 94% within one

day of intervention session.

Thornton,

Jones &

Toohey

(1983)

Sixty-one participants

(Grade 2 -6).

Intervention session held

in a group of 10 students

for each group.

Single-digit addition

and subtraction

problems.

International Journal of Academic Research in Business and Social Sciences

Vol. 9 , No. 3, March, 2019,

E-ISSN: 2222-6990

622

The effectiveness of touch points intervention in improving ASD's student mathematical

achievement

There are numerous researches on new and innovative interventions such as the TouchMath (Bullock

et al., 1989), also known as touch points. Among them are the studies conducted by Avant and Heller

(2011), Berry (2012), Calik and Kargin (2010), Cihak and Foust (2008), Rudolph (2008), Simon and

Hanrahan (2004), Waters and Boon (2011), Wisniewski and Smith (2002), and Yıkmış (2016) which

aims to examine the effectiveness of touch points intervention for children with ASD in solving

fundamental mathematical problems for addition and subtraction topics. These studies showed that

touch point techniques were an effective strategy in helping children with ASD to build and improve

basic mathematical problem-solving skills. While Rudolph (2008) suggested, touch points

intervention continues to be carried out in helping to address the problem of students with low

capability in mastering numeracy basis.

The previous studies showed the touch point method have focused on addition and

subtraction with one and two digits only. Thus, there has been limited research using the touch point

method to develop addition and subtraction for three digits and above. The method also has not

been conducted to build multiplication and division skills. With the effectiveness of mathematical

intervention using touchpoint method in enhancing the addition and subtraction skills as evidenced

Table 1, it is recommended that this touchpoint method should be utilized in multiplication and

division too.

CONCLUSION

The purposes of this systematic literature review are to identify the characteristics of

participants, findings, and suitability of touch point intervention based on the characteristics of

children with ASD. All of the included studies used touchpoint strategy to children with ASD that

focused on basic mathematical skills such as one and two digits addition and subtraction. The findings

expanded the literature by evaluating the quality of the studies, identifying participants'

characteristics, findings and suitability of touch point intervention based on the characteristics of

children with ASD. By all counts and with proven research findings, touchpoints method is considered

by many educators to have been among the excellent teaching aid to help students in progressing

number skills.

Acknowledgment

This work is part of the project that has received funding from the Ministry of Education under the

Fundamental Research Grant Scheme (FRGS/1/2017/SS05/UKM/02/2).

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